Clarithromycin (Biaxin) and Japanese Knotweed

Hi everyone - after a few years of going it alone herbally I'm working with an LLMD and am gearing up to hopefully start the clarithromycin/rifampin combo for bartonella, starting with just the clarithro this month. I'm only still taking Japanese Knotweed in terms of herbs and am unsure of whether to stop or not.

Has anyone ever taken JK with clarithro? Did it work out ok or did you have any adverse experiences?

I'm a little paranoid about starting the drug because I seem to experience a lot of the side effects with most herbs/drugs. This includes chest pain and seeming exercise intolerance from a cardiac standpoint when taking azithromycin awhile ago. I know clarithromycin can also cause heart issues and is in the same drug class. They are reportedly rare but happen more often when clarithro is combined with other drugs/substances and there are interactions. I was reading that both JK and clarithro are cytochrome P450/CYP3A4 inhibitors (but honestly have no idea what this means and if it could mean an adverse reaction). Also, Buhner says JK is a calcium channel adaptogen, which I understand is somehow related to the heart, but again wasn't sure if there was potential on an adverse drug interaction on that front either.

If anyone has any experiences/knowledge to share it would be most appreciated! I could probably quit the JK if I needed to, but if it helps with biofilms/could help cover bartonella from another angle I thought it might be worth staying on, and it has always helped a lot with my symptoms.

Clarithromycin helped me alot, my stomach did not like 500mg 2x day, so I broke out to 250mg 4x day. Was much easier on the stomach. It worked very well on my bart.

I took rifampin wih minocycline. The rifampin was good to 600mg daily. When I reached 900mg daily I crashed badly, I had cysts come up on my tendons, back hurt like heck, urinary frequency and urgency issues + more. I was not getting adrenal support in the form of hydrocortisone and I needed it, my doc missed this, your doc should be discussing this with you and have this rx in place.

The clarithromycin rifampin combo is a very good one, I believe you need to add supplemental folic acid also.

Post Edited (carlnpa) : 2/2/2022 5:37:22 PM (GMT-7)

Buhner states abx and herbs can be combined effectively - he says herbs like knotweed help the penetration of the antibiotics into tissues

most of the actual documented cases of serious heart issues with macrolides in the scientific literature are associated with IV use - rather than oral - and often occur where there are pre-existing risk factors - genetics, advanced age, co-morbidities etc.

i took azithro with high doses of knotweed - around 25g of dry powdered herb per day - and had no issues.

people with lyme can be unduly sensitive to ill effects of any drug or herb for reasons that are not well understood - and individuals can react differently to the exact same treatments - but in general i don't think there is a high risk with combining these